Greene Z K, Smith N R, Gomes T, Lawson N C
*Zachary K Greene, DMD, UAB School of Dentistry, Division of Biomaterials, 1919 7th Ave S, Birmingham, AL, USA.
Nathan R Smith, DMD, MPH, UAB School of Dentistry, Division of Behavioral and Population Sciences, 1919 7th Ave S, Birmingham, AL, 35233
Oper Dent. 2025 May 1;50(3):324-332. doi: 10.2341/24-112-L.
Dental liners are used on caries-free dentin to attenuate postoperative sensitivity and caries-affected dentin to promote remineralization and for antibacterial effects. The shear bond strength of liners to caries-affected and caries-free dentin is a significant clinical property in the restoration of teeth with large caries lesions. Objective: The aim of this in vitro study was to compare the shear bond strengths (SBS) of different liners to caries-free and caries-affected dentin.
SBS specimens were prepared according to ISO 29022:2013(E) (n=10/ group). Caries-free dentin specimens were ground to superficial dentin. For caries-affected dentin, grinding to proximity of carious dentin was performed, remaining caries-infected dentin was removed with a polymer bur, and sanding to 320 grit was conducted to achieve a flat surface. 150-micron thick tape was centered over caries-free or caries-affected dentin, and five different liners (new RMGI-based calcium silicate liner [RMGI/ CS], Biodentine, Lime-Lite Enhanced, TheraCal LC, Vitrebond Plus) were applied to dentin and leveled with the tape. Specimens were treated with adhesive, cured, and bonded with resin composite using the Ultradent fixture. Specimens were stored in 37°C water for 24 ± 2 hours and debonded at 1 mm/min. SBS was analyzed by two-way analysis of variance (ANOVA) and the Tukey post hoc test.
There was a significant difference in SBS among materials for both caries-affected and caries-free dentin (p<0.01). Tukey post hoc analysis grouped materials into significantly different groups for caries-free dentin (Lime-Lite Enhanced, Biodentine < TheraCal LC < Vitrebond Plus, RMGI/CS) and caries-affected dentin (Lime-Lite Enhanced, Biodentine, TheraCal LC < Vitrebond Plus, RMGI/CS). There was no difference in SBS to caries-free and caries-affected dentin for Lime-Lite Enhanced (p=0.359), Biodentine (p=0.522), Vitrebond Plus (p=0.406), or RMGI/CS (p=0.165). SBS was significantly greater to caries-free dentin with TheraCal LC (p<0.01).
RMGI/CS and Vitrebond Plus produced higher SBS to caries-free and caries-affected dentin than the three other materials. There was a higher bond to caries-free dentin than caries-affected dentin for TheraCal LC, but not for any of the other liners tested. Clinicians should balance biologic advantages of liner materials with a decrease in bond strength.
牙衬层用于无龋牙本质以减轻术后敏感性,用于龋损牙本质以促进再矿化及发挥抗菌作用。牙衬层与龋损和无龋牙本质之间的剪切粘结强度是修复大面积龋损牙齿时一项重要的临床特性。目的:本体外研究旨在比较不同牙衬层与无龋和龋损牙本质之间的剪切粘结强度(SBS)。
根据ISO 29022:2013(E)制备SBS标本(每组n = 10)。将无龋牙本质标本磨至牙本质表层。对于龋损牙本质,先磨至接近龋坏牙本质,然后用聚合钻去除残留的龋感染牙本质,再打磨至320目以获得平整表面。将150微米厚的胶带置于无龋或龋损牙本质中央,然后将五种不同的牙衬层(新型基于树脂改性玻璃离子的硅酸钙衬层[RMGI/CS]、生物活性玻璃、Lime-Lite增强型、TheraCal LC、Vitrebond Plus)涂覆于牙本质上并与胶带齐平。标本用粘结剂处理、固化,然后使用Ultradent固定装置与树脂复合材料粘结。标本在37℃水中储存24±2小时,然后以1毫米/分钟的速度脱粘。通过双向方差分析(ANOVA)和Tukey事后检验分析SBS。
对于龋损和无龋牙本质,不同材料之间的SBS均存在显著差异(p<0.01)。Tukey事后分析将无龋牙本质的材料分为显著不同的组(Lime-Lite增强型、生物活性玻璃 < TheraCal LC < Vitrebond Plus、RMGI/CS)以及龋损牙本质的材料组(Lime-Lite增强型、生物活性玻璃、TheraCal LC < Vitrebond Plus、RMGI/CS)。Lime-Lite增强型(p = 0.359)、生物活性玻璃(p = 0.522)、Vitrebond Plus(p = 0.406)或RMGI/CS(p = 0.165)与无龋和龋损牙本质之间的SBS无差异。TheraCal LC与无龋牙本质之间的SBS显著更高(p<0.01)。
RMGI/CS和Vitrebond Plus与无龋和龋损牙本质之间的SBS高于其他三种材料。TheraCal LC与无龋牙本质的粘结高于龋损牙本质,但其他测试的牙衬层均无此情况。临床医生应在牙衬层材料的生物学优势与粘结强度降低之间进行权衡。